In just two weeks, New Zealanders will decide whether euthanasia for the terminally ill is acceptable in the upcoming referendum on the End of Life Choice Act 2019.
It is one of two referenda Kiwis will vote on up until October 17 – the other being the Cannabis Legalisation and Control Bill, which would legalise the sale of cannabis.
For people in New Zealand, they will be able to vote from today. Kiwis based overseas have been able to vote since Wednesday. People must be enrolled to vote in the referendums.
Today, the Northern Advocate discusses the End of Life Choice Act, how Northlanders might vote on the legislation and what local groups for and against the legislation have to say.
If 50 per cent of the population vote in favour of the Act, it would allow people with a terminal illness the option of requesting assisted dying, by either taking or being administered medication to end their life.
Those able to do so must satisfy the following six criteria:
• be aged 18 years or over
• be a New Zealand citizen or permanent resident
• suffer from a terminal illness that's likely to end their life within six months
• have significant and ongoing decline in physical capability
• experience unbearable suffering that cannot be eased
• be able to make an informed decision about assisted dying.
A person would not be eligible to ask for assisted dying if the only reason they give is that they are suffering from a mental disorder or mental illness, or have a disability of any kind, or are of advanced age.
The person's doctor and an independent doctor must agree that the person meets all the criteria, which include being able to make an informed decision about assisted dying.
If either doctor is unsure of the person's ability to make that decision, a psychiatrist must assess the person to decide whether they are eligible. Doctors have the ability to conscientiously object against administering assisted dying medication.
Brent Colley, a bus driver from Opononi, said he was unsure of his position on the Act as he saw both positives and negatives to its implementation.
"I just think it's open for abuse, [but] I sort of agree with it that some people are at the end of their life."
Colley said the ability to end one's life should be possible in some cases, such as his father's, who died after a two-year struggle with cancer.
Whangārei's Robin Lieffering has been a member of the local End of Life Choice Society for about three decades and has been a strong supporter of euthanasia since her 84-year-old mother, Olive, died five years after suffering a stroke.
"[Olive] was outdoorsy, she rode horses until she was nearly 60, bodysurfed until she was 78 and then she had the stroke," Robin said.
"Then she lay on her bed, unable to speak, unable to move, unable to do anything and it took five years [until she died]."
Under the proposed Act, Olive would still not have been able to end her life. However, 80-year-old Robin said the option of euthanasia was important for those entering life's final stages.
"I think everybody of my age realises that the very next challenge they're facing is dying, and we all think, 'how is it going to be'.
"Am I going to be lucky and go to sleep, or am I going to be very unlucky and suffer some ghastly final illness?
"One of the things that will give me comfort is to know I will have that option [of euthanasia]."
One of the strongest opponents of the Act and euthanasia is Hospice, an organisation which provides palliative care for people with life-limiting conditions.
In a recent media release, Whangārei's North Haven Hospice confirmed it would conscientiously object from providing euthanasia with no staff to be involved in "the administration or be present during the administration of euthanasia medications".
North Haven Hospice medical director Dr Warrick Jones said euthanasia, and the Act by extension, compromised one of Hospice's core values of not hastening death.
"To deliberately give medication to kill someone falls very much outside [of that]," he said.
Jones believed the proposed Act, through which a person could potentially end their life in a matter of days, didn't have the necessary safeguards to ensure such decisions were not made rashly.
"People's thoughts change, emotions change … it's a sad thing, it's an uncomfortable thing, but thoughts and feelings change through that journey."
He also raised concern with how, under the Act, a person could end their life without informing their family, as well as the potential for the legislation to be widened to allow more people to end their life prematurely – a concept termed "the slippery slope".
The University of Otago's Jessica Young has recently completed her PhD titled; "Agency, uncertainty and power: Why people consider assisted dying at the end of life".
In her study, Young spoke with New Zealanders considering assisted dying, as well as their family members, about why they saw euthanasia as an important option for those nearing the end of their life.
Young, who had also completed other research on the topic, said her study found the option of euthanasia for those at the end of their life was a valuable one.
"People don't want to die but they don't have a choice to continue living, so [it's about] having control over how and when they die if they are dying badly," she said.
"If they are not dying badly, then it's all well and good, [euthanasia is] an option of last resort."
Young cited one woman participant in her study who believed the question of euthanasia for her came down to quality, not quantity of life.
"She was willing to accept that she might have less time because it was about the quality of her life rather than the quantity of her life, it was about living a meaningful, quality life for her," Young said.
Referencing the Act, Young said its conditions were still very narrow and some supporters of euthanasia would be disappointed about how many people fell outside the criteria.
However, she rebutted Jones' concerns over its safeguards. Regarding the time it would take someone to end their life, Young said it was "highly unlikely" the process would start and end in a matter of days, instead saying it would most likely take months given the struggle to find doctors and to ensure there was no question of someone's capacity to make the decision.
Given the Act's narrow scope of influence, Young believed the concept of the "slippery slope", which had been observed in Belgium and the Netherlands where euthanasia legislation had been widened, was unlikely in New Zealand.
"In my opinion, you won't see that widening of the law and if there were to be any of that, then it would have to go through parliamentary process and public consultation."
For those who supported euthanasia but had concerns over the proposed Act, Young still advised them to vote in favour of the Act as the topic would likely fall into obscurity should the referendum be voted down.
"If you believe in this, this is the time to vote yes, otherwise [Parliament] might not touch it for a long time."